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HomeMy WebLinkAboutPermit EL19-0807 - KNIGHT RESIDENCE - 22 SILFAB MODULES ON ROOFKNIGHT RESIDENCE 14919 41ST PL S ELI 9-0807 City of Tukwila ent of Community Development ��""��°����^����.��.`�^ Suite #100 """""°""."=."��""�"="'"".,"^°" ' / Tuk�i|a,VVash|ngton981OQ �~' n Phone: -�ns~«n�'s7n ''— ----- Inspection Request Line: 206-438-E350 Web site: http://www.TukwilaWA.gov Parcel No: Address: Project Name: 0041000247 14919 41ST PL S KNIGHT RESIDENCE ELECTRICAL PERMIT Permit Number: EL19'0807 Issue Date: I0/30/2019 Permit Expires On: 4/27/2020 Owner: Name: Address: Contact Person: Name: Address: Contractor: Name: Address: License No: Lender: Name: Address: KNIGHT EDWARD V SR+EVA M PO BOX 68684 , SEATTLE, OR, 98168 GRANT HARLEY ]2U5VVCENTURY DR, #4O5'388' BEND, OR, 97702 BRIMMA SOLAR LLC 261Ol1THAVE E,SEATTLE, WA, 98102 8K|MMS0Z0 ^'' Phone: (253) 507-2337 Phone: (206) 877-2818 Expiration Date: 5/11/2020 DESCRIPTION OF WORK: INSTALLING 22 SILFAB MODULES ON ROOF OF EXISTING HOME. 300 WATTS EACH FOR A TOTAL OF 6.6 KW. APYC600 INVERTERS. Valuation of single family: $2/000.00 Valuation of mf/comm: $0.00 Type of Work: SERV CHNG Fees Collected: $I60.68 Electrical Service Provided by: SEATTLE CITY LIGHT Water District: 125 Sewer District: VALLEY VIEW Current Codes adopted by the City of Tukwila: International Building Code Edition: International Residential Code Edition: International Mechanical Code Edition: Uniform Plumbing Code Edition: lnternational Fuel Gas Code: Permit Center Authorized Signatu 2015 20152015 2015 2015 National Electrical Code: WA Cities Electrical Code: WAC 296-46B: 2017WA State Energy Code: 2017 2017 2015 I hearby certify that | have read and examined this permit and know the same to be true and correct. All provisions of law and orchnances governing this work will be complied with, whether specified herein or not. The granting of this permit does not presume to give authority to violate or cancel the provisions of any other state or Iocal laws regulating construction or the performance of work. 1 am authorized to sign and obtain this development permit and agree to the conditions attached to this permit. Signature: Print Name: This permit shal! become null and void if the work 15 not commenced within 180 days for the date of issuance, or if the work is suspended or abandoned for a period of 180 days from the last inspection, PERMIT CONDITIONS: <NONE> PERMIT INSPEC11ONS REQUIRED Permit Inspection Line: (206) 438-9350 2100 ELECTRICAL FINAL 7003 ROUGH -IN ELECTRICAL 7002 SERVICE 700I UNDERGROUND/SLAB CITY OF TUKWILA Community Development Department Permit Center 6300 Southcenter Blvd., Suite 100 Tukwila, WA 98188 http://www.TukwilaWA.gov Electrical Permit No. q 90 -Project No. Date Application Accepted: t Date Application Expires: (For office use of:1y) ELECTRICAL PERMIT APPLICATION Applications and plans must be complete in order to be accepted for plan review. Applications will not be accepted through the mail or by fax. **Please Print** SITE LOCATION 00 - King Co Assessor's Tax No.: 4/00 Site Address: / q sy-- PL s Suite Number: Floor: Tenant Name: New Tenant: PROPERTYONVNER Company Name: 60 miriA .Sli kr.. Address: Dr4t7ioc- Name: c– ct, tiva_r_.3 v....1,\\,51„1/4„ -v -- City: S te: i Phoiwoo.. 0,e. , I Fax:g . , . 777g_ Address: 1 4„, t et i.A.is,..+ eL s Tulcwila Business License No.; City. ----State' I LiLAe—kil I ol, , (-ki A 1 Pr / 40 8 C�NTCT person receiving all project comrnunication ra-h+ y Address: 3a 0 (A) vrk Name: City: 6 I Ste:R Zi v isges P '7 7 o Phone? s 3 5. 0 7 _ Email: ra..54 e br vvta So kr, a Elm Yes E] ..No ELECTRICAL CONTRACTOR INFORIVIATION Company Name: 60 miriA .Sli kr.. Address: Dr4t7ioc- 3a. 0 s tv City: S te: i Phoiwoo.. 0,e. , I Fax:g . , . 777g_ Contr Rea No.: . ak I LA'IS t_. fa 4/- K,T Exp Date: _Slit 4-o Tulcwila Business License No.; Valuation of Project (contractor's bid price): $ Scope of Work (please provide detailed information): / / / Q Sik.L rvioaLd-es VI k Ere CYC (q+1 ervvi e. 300 i e(cL, L kik), m)Nic yi ve4464.---c Will service be altered? 0 Yes ,. No Type of Use. Adding more than 50 amps'? Yes 10 No Type of work: 11 New LJ Addition El Service Change 1:1 Low Voltage fl Generator El Fire Alarm Property Served by: Puget Sound Energy Seattle City Light W:Wennit CenterlApplicatious-Handouts \ Permit Applications PDFsWlectrical Permit Application Revised 1-17-19.clocx gRemodel 0 Telecommunication rj Tenant Improvement 0 Temporary Service Page 1 of 2 RESIDENTIAL NEW RESIDENTIAL SERVICE LJ New single family dwellings (including an attached garage) 1:1 Garages, pools, spas and outbuildings • Low voltage systems (alarm) $180.00 $120.00 ea $60.00 ea RESIDENTIAL REMODEL AND SERVICE CHANGES O Service change or alteration $120.00 (no added/altered circuits) O Service change with added/altered circuits $100.00 number of added circuits $10.00 ea Circuits added/altered without service change $60.00 (up to 5 circuits) • Circuits added/altered without service change $60.00 (6 or more circuits) $10.00 ea O Meter/mast repair $80.00 O Low voltage systems $60.00 (alarm, furnace thermostat) MULTI -FAMILY AND COMMERCIAL Fees are based on the valuation of the electrical contract. MISCELLANEOUS FEES 0 Temporary service (residential) $60.00 • Temporary service (generator) $90.00 1:1 Manufactured/mobile home service $100.00 (excluding garage or outbuilding) • Carnivals $100.00 Number of concessions $11.00 ea Each ride and generator truck $11.00 ea ***EFFECTIVE JANUARY 1, 2014 EACH PERMIT WILL BE ASSESSED A 5% TECHNOLOGY FEE*** PERMIT APPLICATION NOTES - Value of Construction — In all cases, a value of construction amount should be entered by the applicant. This figure will be reviewed and is subject to possible revision by the Permit Center to comply with current fee schedules. Expiration of Plan Review — Applications for which no permit is issued within 180 days following the date of application shall expire by limitation. The Building Official may grant one extension of time for an additional period not to exceed 90 days. The extension shall be requested in writing and justifiable cause demonstrated. I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE UNDER PENALTY OF PERJURY BY THE LAWS OF THE STATE OF WASHINGTON, AND I AM AUTHORIZED TO APPLY FOR THIS PERMIT. BUILDING OWNER OR ELECTRICAL CONTRACTOR: Signature: Print Name: Mailing Address: 3 2 0 j CJ-A.r1 D. 6,ck WAPermit Center\ Applicatim-HandoutsTennit Applications \ PDPsTlectrical Permit Application Revised 1-17-19.dacx Date: D/ 9 Day Telephone: 24-3 • 0 L3 7 ° City State Zip Page 2 of 2 DESCRIPTIONS PermitTRAK Cash Register Receipt City of Tukwila I ACCOUNT 1 QUANTITY PAID 60.68 EL19-0807 Address: 14919 41ST PL S Apn:,0041000247 160.6 Credit Card Fee $4.68 Credit Card Fee R000.369.908.00.00 0.00 $4.68 ELECTRICAL $150.00 PERMIT FEE SINGLE FAMILY R000.322.101.00.00 0.00 $120.00 PLAN CHECK FEE R000.345.832.00.00 0.00 $30.00 TECHNOLOGY FEE .00 TECHNOLOGY FEE TOTAL FEES PAID BY RECEIPT: R18718 R000.322.900.04.00 0.00 $6.00 $160.68 Date Paid: Tuesday, October 01, 2019 Paid By: LYNNETTE HARLEY Pay Method: CREDIT CARD 08054G Printed: Tuesday, October 01, 2019 11:46 AM 1 of 1 CRWY5TEMS CO TUKWILA ETRAKIT 6200 SOUTHCENTER BLVD TUKWILA, WA 98188 206'433-1878 CITY OF TUKWILA Date: 10/01/2019 I1:46:01 AM CREDIT CARD SALE VISA CARD NUMBER: **********2494 K TRAN AMOUNT: $160.88 APPROVAL CD: 08054G RECORD #: 000 CLERK ID: Bill Thank you! Customer Copy INSPECTION RECORD Retain a copy with permit INSPECTION NO. PE MIT NO. CITY OF TUKWILA BUILDING DIVISION 6300 Southcenter Blvd., #100, Tukwila. WA 98188 (2.06) 431-3670 Permit Inspection Request Line (206) 438-9350 Project: Type of nsp c on: Address: /1°0 I Date Called: Special Inst uctio s: Pk/ Date Wanted: a.m. p.m. Requester: Phone No: 2_55 56 7 z537 Approved per applicable codes. OMMENTS: Corrections required prior to approval. REINSPECTIOP4 FEE REQUIRED. Prior to next inspection. fee must be paid at 6300 Southcenter Blvd.. Suite 100. Call to schedule reinspection. SEPARATE PERMIT REGI IRED FOR: 3' Mechanical ❑,�.Electrical t� Plumbing gr Gas Piping City of Tukwila BUILDING DIVISION V NFPA 0 SEP 18 2019 City of Tukwila BUILDING DIVISIO REVISIONS No cares shall be made to the scope of work without pi ,o: approval of the Tukwila Building Division. NOTE: Revisions will ieauire a new plan submittal and may Include additional plan -review. Pam* NaL p �� S07 Plan review approval Is subject to errors and omissions. Approval of construction documents does not authorize the violation of any adopted code or ordinance Receipt of approved Field Copy and coni tions 15 acknowledged: By. c,rli Date: / (O/ 3cv1 ' City of Tuxwila BUILDING DIVISION EL l q-OSo7 f ECE VEr) CITY OF TUKW LA OCT 01 2019 PERMIT CENTER 1N Solar array on roof Modules 40"x65" micro inverters uncer modules 0 0 Installation complies with RS402 and IFC 605.11,1.2 1 story roll on comp roof 5 deg slope 2x4' Engineered trusses every 24" 00 CIT ititilify meter next to production meter, OCPD and disco. Panel in some. Driveway to 41st PI OCT p12019 PERM' CENT Cky of T SUILDING ila SION Job: Knight 1491941st PIS Tukwila, WA 98168 PV Module PV Module Conductors= #10 AWG THHN in 314" EMT or FMC Ground # 8AWG Distance 60' 12 Modules with a total of 6 YC600 Micros 10 modules with a total of 5 YC600 Micro Inverter Cable Black - L1 Red - L2 Green -Ground PV Module PV Module Modules grounded per 690.43(C) Oh listed Sunmodo grounding PV Module Ratings Manufacture: Sil-Fab Model #: SLA -M -W Open -Circuit Voltage: 38,0V Operation Voltage: 30V Max String Voltage: 600V Operating Current: 8,2A Short -Circuit Current: 8,7A Max Series Fuse: 15A Maximum Power(STC): 300W VOC Temp Coeff: -.432%C Breaker box with branch OCPDs 20A • ti Production Meter Inverter Specs: Manufacture: APSystems Module: YC600 Max Output Current: 2,28A Nominal Output Volts: 240V Output Frequency: 59,3hz-60.5hZ Output Volt Range: 211V -264V Total number of Modules: 22 System Size: 6.6 kW Utility Met 8I CH -Tan Split Bus 00® ® Conductors= #8AWG Ground # 8AWG Distance 5' Ci AC Point of Interconnection (NEC 690.54): Rated AC output: 25.08A (#of invertersX2.28A) Nominal AC Voltage: 240V oic4LA OCTo32019 t4tER -4 •-4----I -4/„.4741-1 F ---4 •-4---• — \ r\ _r "--qy .- 35A or 40A V.11F1" wNP c- EG SEP 181019 City of Tukwila UILDING DIVISION 0 Job: Knight Address: 14919 41st PI S Tukwila, WA 98168 I3FZIMMA Solar APsystems ALTENERGY POWER Leading the Industry in Solar Microi venter Technology DIMENSIONS WRING SCHEMATIC VI EFOF-- OOi PLIANCE WIT1ii NFPA 770 - NEC SEP 1 B 2019 City of Tukwila BUILDING DIVISION 1.24" Meets NEC 201'/2017 600..1.2 Rapid Si- airernents 0orrini ate!- &free of ,tflnac; With its groundbreaking design and features, the YC600 is the pinnacle of microinverter technology. A single-phase, smart grid -compliant microinverter, the YC600 serves two modules with dual, independent MPPT. Zigbee wireless communication over a mesh network offers faster data speeds than PLC and a wider MPPT voltage range results in a greater energy harvest for homeowners. A true utility -interactive microinverter with Reactive Power Control (RPC) technology, the YC600 meets CA Rule 21 requirements and is inherently NEC 2014/2017 Rapid Shutdown compliant. The unit also builds on the successful APsystems line of multi -module microinverters, simplifying installation and reducing logistics costs. MOM ItIMIk if!■/ira.. ■f•ia11i■ 1ivasNi au ■i1 .... ■ MUM 111111111111111• 1111 ■■U■MA aa■u111M MUM i■■11Uu■ /L...ai u....ta■ URRURUUi ■■■..... •.....i \19i • tl l 11 tei c TY OF r r OCT 01 2019 —rE LIrT CENTER APsystems YC600 Microinverter Datash et INPUT DATA (DC) Module Compatibifty MPPT Voltage Range Operation Voltage Range Maximum Input Voltage Maximum Input Current Maximum Total PV Array Short Circuit Current (U1.. + ... DATA ' ( C Maximum Continuous Output Power Peak Output Power Nominal Output Voltage Nominal Output Current Nominal Output Frequency Adjustable Output Voltage Range Adjustable Output Frequency Range Power Factor (Adjustable) Total Harmonic Distortion Maximum Units per Branch EFFKIENcY Peak Efficiency CEC Weighted Efficiency Nominal MPPT Efficiency Night Power Consumption MFCH NI AL DATA Operating Ambient Temperature Range Storage Temperature Range Dimensions (WxHxD) inches Dimensions (WxHxD) mm Weight • AC BUS Maximum Current Connector Type Enclosure Rating Cooling Communication Transformer Design Monitoring Emissions & Immunity (EMC) Compliance Safety & Grid Connection Compliance Depending on the local regulations. "APsystems online Energy Management Analysis (EMA) platform Specifications subject to change without notice - please ensure you are using the most recent version found at APsystems.com 60 & 72 Cell PV Modules 22V -48V 16V -55V 60V 12A x 2 15A 240V 548VA 600VA 240V 2.28A 60Hz 211-264V 59.3 - 60.5Hz 0.8 leading...0.8 lagging <3% 7 (14 PV modules) 96.7% 96.5% 99.5%' 60mW 208V 548VA 600VA 208V 2.63A 60Hz 183-229V 59.3 - 60.5Hz 0.8 leading...0.8 lagging <3% 6 (12 PV modules) -40°F to +149°F (-40°C to +65"C) -40°F to +185°F (-40°C to +85°C) 10.24" x 7.4" x 1.24" 260mm x 188mm x 31.5mm 5.7 lbs (2.6kg) 20A MC4 Type NEMA 6 ( IP67 ) Natural Convection - No Fans Wireless Zigbee High Frequency Transformers, Galvanic Isolation Via EMA"Online Portal FCC PART 15, ANSI C63.4, ICES -003 UL1741, UL1741 SA, IEEE1547, CSA C22.2 No.107.1-01, NEC_ 2017 690.12, 690.11, CA Rule 21 600 Ericksen Ave NE, Suite 200, Seattle, WA 98110 i 844.666.7035 I APsystems.com 6.28.78 'S All Rights Reserved APsystems ALTENERGY POWER �-` 100% MAXIMUM POWER DENSITY Silfab's SLA'K43OUultra'high+efficiency modules are optimized for both Residential and Commerdal projects where maximum power density is preferred. 100% NORTH AMERICAN QUALITY MATTERS Silfab's fully -automated manufacturing facility ensures precision engineering is applied at every stage. Superior reliability and performance combine to produce one of the highest quality modules with the Iowest defect rate in the industry. NORTH AMERICAN CUSTOMIZED SERVICE Si|fabs North leverages just -in -time rOrittifiaatirthgt‘q iv4r unparalleled servesUrttilidedAiirAcILI*1 flexible project solutions. OCT 0 1 2019 ~ `~ 8 �7P1 �� �w ENSURES MAXIMUM EFFICIENCY 60 ofthe highestefficiency, premium qua|b/monocgot Uinc cells result in a maximum power rating of300Wp. ADVANCED PERFORMANCE WARRANTY 30 -year linear power performance guarantee ENHANCED PRODUCT WARRANTY BUILT BY INDUSTRY EXPERTS With over 35 yearof ndustry experience, Silfab's technical team are piorieers in PV technology and are dedicated to an innovative approach that provideserior manufacturing processes including: infra -red cell sorting, glass washing, automated sotdering and meticulous cell alignment. POSITIVE TOLERANCE (-0/+5VV) Afl positive module sorting ensures maximum performance LOWEST DEFECT RATE* Total automation ensures strict quaIty control during each step of the process at our certified 150 manJfacturing facilllty. *82.56 ppm as per December 2017 LIGHT AND DURABLE Over -engineered to weather ow load bearing structures uo to 5400 Pa. Light -weight frame exdusively desgied with wide-ranging racking compatibility and durability. PID RESISTANT Proven in accordance to IEC 62804-1 AVAILABLE WITH , ^ Black Frame and Backsheet oyear, extendable based omregistration v,www six^usolamm Electrical Specifications LFAB SLA Monocrystailine Test Conditions Module Power (Pmax) Maximum power voltage (Vpmax) Maximum power current (Ipmax) Open circuit voltage (Voc) Short circuit current (Isc) Module efficiency Maximum system voltage (VDC) Series fuse rating Power Tolerance P V A V A STC 300 32.8 9.16 39.85 9.71 18.4 V 1000 NOCT 227 29.5 7.69 36.9 7.96 A 20 Measurement conditions: STC 1000 W/m2 • AM 1.5 • Temperature 25 °C • NOCT 800 W/mW • AM 1.5 • Measurement uncertainty s 3% • Sun simulator calibration reference modules from Fraunhofer Institute. Electrical characteristics may vary by ±5% and power by -01+5. 17.3 Temperature Ratings Si LFAB SLA MnnoCry e:; Temperature Coefficient Isc Temperature Coefficient Voc Temperature Coefficient Pmax NOCT (± 2°C) %/K g%/K %/K or 0geratin temperature °C 0.03 -0.30 -0.38 45 -401+85 _ Mechanical Properties and Components FAB SLA IVIonocrystaiiine. Module weight (± 1 kg) Dimensions (HxLxD;±1mm)_ Maximum surface load (wind/snow)* Hail impact resistance ".. k mm N/m2 Cells Glass Backsheet Frame Bypass diodes Cables and connectors (See installation manual) 19 1650 x 990 x 38 5400 0 25 mm at 83 km/h 60 - Si monocrystalline - 4 or 5 busbar - 156.75 x 156.75 mm 3.2 mm high transmittance, tempered, antireflective coating Multil er Polyester -based Anodized Al 3 diodes-45V/12A, IP67/IP68 1200 nun 0 5.7 mm (4 mm2), MC4 compatible Warranties SILFAB SI Monocr stailine Module product workmanship warranty Linear power performance guarantee 25 ears 30 years Certifications SILFAB SLA Monocrystailine Product ULC ORD C1703, UL 1703, IEC 61215, IEC 61730-1 and IEC 61730-2 Certified. FSEC and CEC listed. IEC 62716 Ammonia Corrosion, IEC 61701:2011 Salt Mist Corrosion Certified Factory Warning: Read the installation and User Manual before handling, installing and operating modules. Third -party generated pan files from Fraunhofer -Institute for Solar Energy Systems ISE are available for download at: www.silfabsolar.com/downloads .:3 Modules Per Pallet: 26 .:e Pallets Per Truck: 36 Hi Modules Per Truck: 936 ��DQ P2017 Mie;, APV MOOIll£� RELIAISILI YSCORECARD Silfab Solar Inc. 240 Courtneypark Drive East Mississauga ON L5T 2Y3 Canada Tel +1 905-255-2501 1 Fax +1 905-696-0267 info@silfabsolar.com 1 www.silfabsolar.com Silfab Solar Inc. 800 Cornwall Ave Bellingham WA 98225 USA Tel+1 360-569-4733 UL Fire Rating: Type 2 (Type 1 on request) 1509001;2015 38 Drainage (s8)� o B ®H Grounding Note Mounting Slot 04.2 l.2) is Profile t 10 C -C View 28 lcf J 1 s, Grounding Hole All Dimensions in mm Tolerances: nmol Hole tolerance.: SO.Rmm Drawings net le scale r 958 s 990 bout notice. ©S Ifab, 2018. rmation is subject to modiflc 0 a 70 F -0G-20181010-8 • SUNMD7J SunModo is focused on innovative racking and mounting solutions for professional installers in the fast-growing solar industry. Our solar mounting system features a patented grounding and bonding scheme that is designed into the mounting hardware for rails, clamps and splices. All self -grounding hardware meets NEC 690.43, UL27o3 Grounding and Bonding and UL17o3 Class -A Fire Rated for Type and 2 PV modules tested by ETL. THE EZ ROOF MOUNT SYSTEM offers one of the most versatile, installer -friendly pitched roof mounting systems on the market. Our patented easy-to-use flagship EZ Roof Mount anchor 3ooMW in installed capacity. With a full range of mounts and components, our pitched roof system can be configured in an endless variety of designs. In addition, SunModo offers a variety of mounts, from shingle to metal roof, to best fit your system needs and requirements. qq O@FO NFPA70-N-C Cr.? 18 2019 All system components have been UL27o3 tested by ETL for electrical continuity, eliminatin' the nee for additional grounding hardware. city of Tukwila BUILDING DIVISION EZ Roof Mount Family Portrait Mid Clamp Helio aluminum extrusions with corrosion resistant anodized coating Landscape Mid Clamp Self DUnding Splice CITY LUiI" Til: �'s bt LA Landscape End Clamp Grounding Lug UL 467 tested by ETL 9ERMIT COORD COPY PLAN REVIEW/ROUTING SLIP PERMIT NUMBER: EL19-0807 DATE: 10/01/19 PROJECT NAME: KNIGHT RESIDENCE SITE ADDRESS: 14919 41 FL S X Original Plan Submittal Revision # Response to Correction Letter # before Permit Issued Revision # after Permit Issued DEPARTMENTS: IWC [-L4-.1 Building Division Public Works T Fire Prevention Structural ..I•••••• Planning Division Permit Coordinator 1111 PRELIMINARY REVIEW: Not Applicable ri (no approval/review required) REVIEWER'S INITIALS: DATE: 10/03/19 Structural Review Required DATE: APPROVALS OR CORRECTIONS: Approved Corrections Required (corrections entered in Reviews) DUE DATE: 10/31/19 Approved with Conditions Denied (ie: (ie: Zoning Issues) P Notation: REVIEWER'S INITIALS: DATE: Permit Center Use Only CORRECTION LETTER MAILED: Departments issued corrections: Bldg 0 Fire 0 Ping 0 PW 0 Staff Initials. 12/18/2013 0 Home Espol Contact: [Search L&I Safety & Health Claims & Insurance Ck Washington State Department of 'Labor & Industries A -Z, Index Help Nly "MI Workplace Rights Trades & Licensing BRIMMA SOLAR LLC Owner or tradesperson Principals HARLEY, JOHN WILLIAM, MANAGER LANCASTER, JANELLE ELAINE, MANAGER Doing business as BRIMMA SOLAR LLC WA UBI No, 603 046 671 320 SW Century Dr suite 405-388 BEND, OR 97702 206-877-2818 Business type Limited Liability Company Governing persons JANELLE LANCASTER JOHN HARLEY, License Verify the contractor's active registration / license / certification (depending on trade) and any past violations. Construction Contractor License specialties GENERAL License no. BRIMMSL899CQ Effective — expiration 02/18/2011— 02/18/2021 Bond RLI Ins Co Bond account no. LSM0415679 Active Meets current requirements. $12,000.00 Received by L&I Effective date 11/02/2012 11/02/2012 Expiration date Until Canceled Insurance Gotham Inc Co $1,000,000.00 Policy no GL201900013168 Received by L&I Effective date 07/18/2019 07/20/2019 Expiration date 07/20/2020 Insurance history Savings No savings accounts during the previous 6 year period. Help us improve